Root to crown: Advanced adhesive endodontic/restorative concept

After this lecture, participants should be able to identify clinically relevant factors for the restoration of nonvital teeth and teeth with challenged vitality, determine the need for different adhesive tools to construct the buildup of the abutment tooth with fiber posts and various resin composites, and describe critical details of the ideal final restoration of nonvital teeth.

Long-term data show that survival of nonvital teeth has always been a challenge. Both endodontic and restorative dentistry contribute critically to the treatment outcome. The concept of care presented in this lecture has been developed by both endodontists and prosthodontists over 18 years of cooperation. It is based on four main ideas common to both fields: tissue preservation (unnecessary hard dental tissue loss should be prevented), replacement with similar materials (lost tissue should be replaced with material of similar physical properties), adhesion (all components of the restoration should adhere to each other) and safety (when failure occurs, it should not be catastrophic). Over the years, the protocol has been extended from nonvital teeth only to teeth with compromised integrity and challenged vitality. The endodontist delivers a ready-to-use abutment tooth free of pathology for the final restoration regardless of the tooth vitality. In this lecture, the decision-making process, material selection, complete workflow and long-term outcomes will be presented.